Czech Healthcare Adventure! Part II

I've been on a real Bob Ross kick lately. My mom used to watch it when I was a baby and my grandfather painted along to his happy little creeks and cabins with roofs full of snow in his old age. There's a Twitch stream that plays all of the episodes, even the ones where Bob's son and his glorious mullet do a guest spot. I go to sleep at night listening to Bob describe a squirrel he rescued and named Peapod and his soothing ramblings about combining colors, techniques, and tales Florida and Alaska. It's very zen, something I've sought after for much of my life. 

YES, YES THEY ARE.

Today I went to my first "diabetologie" appointment. The Czechs are specific when it comes to medical care, meaning that instead of seeing an endocrinologist like I would in the US to treat Type 1, I see someone who specializes in only diabetes and not other endocrine disorders. It was a relief knowing I wouldn't have to explain my disease to a professional who may not know all of the ins and outs of dosages, regimens, numbers, and time tables. Unfortunately, this has happened before. It's like if you woke up during open heart surgery and told the doctor "here why don't you let me take over for a bit."

St. Anne's University Hospital, or"fakultni nemocnice u vs Anna v Brne" as I've learned to refer to but not pronounce, is a sprawling campus of old Soviet buildings, newer, pristine architecture, and baroque moldings near the center of Brno. The map I downloaded to find "Building J" was color-coded but also in Czech, so I did that thing where you walk one way while watching your location on GPS to see if you are indeed heading in the right direction. Building J did exist, however it was quite a hike around the campus to locate it. At one point I wondered if it was maybe like the Back Building in Mean Girls.

With a low ceiling and steel chairs lining the hallways, I wasn't sure if I was going to a diabetologist as much as I was going to be contacting any form of asbestos. These hallways had seen better days with their scuffed patterned floors and shredding yellow and orange wallpaper.

On Pinterest it might be referred to as"Shabby chic!" I found a hallway full of doors and outside each door was a vinyl bench with no form of support.

The door with my doctor's name on it had people going in and out of it so I figured this must be a good thing. They're not being wheeled out of the room with a respirator or a blue face. So far, so good.

Like if this room was a hospital.

I have now spent enough time here to know that when you see a chair or an area for waiting, that's where you wait, which sounds obvious but if you go further to investigate behind doors that aren't marked clearly, a woman named Petra may scold you in Czech until you just sit anywhere close by until you're officially retrieved. So I sat and waited outside. 

For Czech people, my last name is pronounced "Dawn-uh-hoo-ee." With the stress on the first syllable and no accessible diphthongs, I've learned to listen for various covers of my surname from people I don't know. A young nurse fetched me and my seemingly normal last name from the hall and brought me into a large examining room and office which didn't look like it belonged inside the semi-decrepit Building J. Brightly lit with new furniture, recently manufactured medical supplies and machinery, and surfaces free of dust or minerals, the nurse who spoke some English informed the doctor I had Type 1 and that I needed a new blood glucose meter and the appropriate test strips. Certain test strips only work with certain meters, and since I couldn't buy strips in Metric meant for an Imperial Measurement System meter, I needed a whole new kit. They spoke back and forth in Czech for a moment and then came the question: "Insurance?"

I signed up for state health insurance after my visa was approved, but my insurance card still hasn't arrived in the mail. I also didn't have anything on me that proved I was technically in the system, so in this circumstance, I basically didn't have insurance at all. I showed them my traveler's insurance, which only covers you in the event of a nuclear apocalypse or emergency treatment upwards of $200,000, but they shook their heads. They continued to talk in Czech as I brought out my bag of supplies filled with both types of insulin, spare needles, my glucose meter, and test strips. I could have just been some random person who came off the street, so I wanted to show them that I currently have the supplies needed for someone with Type 1. In broken English, the nurse said, "We give you a meter and test strips free, and in two weeks you come back when your insurance card comes, yeah?" 

Umm, fuck yeah. I smiled like an idiot and said "ano, ano prosim." Getting a free glucose meter and the accompanying strips in the United States means getting one from a diabetic friend or selling your first born and sometimes second born. One of the reasons people with diabetes let their care suffer during a financial crisis is because they simply can't afford the test strips, let alone the insulin. I test my blood sugar four to five times a day depending on when I'm eating and how long I'm awake. In the United States, a pack of 100 test strips without insurance is $129, meaning every 20 days, I'm out $129 if I actually want to manage and treat my disease instead of slowly die. Test strips are a HUGE inconvenience. You need them to figure out how much insulin to give yourself before meals and to find out if you really do have low blood sugar or if you're just imagining it. Getting 100 of them for free in addition to the hardware is a big deal. 

Woo! Czech glucose meter!

The nurse who spoke some English and another nurse who spoke zero English physically acted out how I'm supposed to use the meter. Even though I've been testing my blood sugar for almost eight years, I couldn't bring myself to stop their comedic safety demonstration. The Czech nurse poked her finger and said "owwwiiieeeee!" and then blew on it to exhibit the minor pain and inconvenience of pricking myself. "Into blood!" Aren't we all. They packed up my new kit and sent me into my doctor's actual office where he asked me some basic diabetes related questions: when were you diagnosed, at what age, what symptoms were you experiencing, how often do you go low, and which insulins are you on. I brought out my bag of supplies and showed him the insulins I use. One insulin I use is what's called a basal insulin and lowers me to a healthy "baseline" for 24 hours.

I use the other insulin before meals or when I'm consuming carbs, which can only be done every 4-5 hours. 

He recognized both pens and told me he would give me prescriptions when I came back in two weeks once my health insurance card had arrived.

Basaglar and Humalog, the two insulins I need to use.

Insulin pen with a teeny tiny needle.

Then my doctor told me, "I'm not going to charge you for today since you only needed a meter and there's no exam. When you come back in two weeks, your insulin prescriptions and the appointment will be covered. If you need any lab work done, that will be covered, too."

I was floored. I smiled at him and almost cried. Normally in the Czech Republic you need cash in hand, although not much, before any medical appointment if you don't have health insurance for your visit. I was expecting to pay something today, but not nothing. If this was the situation in the United States, I might need to start a GoFundMe to cover the costs of staying alive. I told him that it wasn't this easy in the US. "We know," he told me. 

Finally, a country that understands that staying alive is a basic human right. If we were brought into this world without consent, there should be an economic and social system in place to make sure we can be the healthiest capable people contributing to society. Why is that so hard to understand? If the US has such a hard on for being the greatest economy, shouldn't we have a healthcare system in place that takes care of the people who put forth the effort and time to stimulate a "great" country?

After gleefully leaving the hospital, I literally skipped back to the tram stop and went to teach for the afternoon. I showed the other teachers my new rig and spent the next few hours going over phrasal verbs, how "synonym" and "cinnamon" are two entirely different words, and the correct pronunciation of "hyperbole." I'll update again in two weeks after my next diabetology appointment. If the Czechs keep taking care of me like they are, I'm going to be here for a long time.